PMID- 36069160
OWN - NLM
STAT- MEDLINE
DCOM- 20221215
LR  - 20230413
IS  - 1096-9101 (Electronic)
IS  - 0196-8092 (Print)
IS  - 0196-8092 (Linking)
VI  - 54
IP  - 10
DP  - 2022 Dec
TI  - Long-term improvement in the appearance of hypertrophic scars following a single 
      treatment with acoustic subcision-A single center proof-of-concept study.
PG  - 1251-1260
LID - 10.1002/lsm.23596 [doi]
AB  - INTRODUCTION AND OBJECTIVES: Fibrosis, including hypertrophic scar formation, is 
      a pathological condition characterized by excessive production and accumulation 
      of collagen, and loss of tissue architecture, in response to wound healing. 
      Alterations in the extracellular matrix (ECM) biomechanical properties may be 
      important in modulating myofibroblasts and fibrosis formation. The acoustic 
      subcision device uses rapid acoustic pulse technology to noninvasively improve 
      the appearance of hypertrophic scars through both microdisruption of scar tissue 
      matrix and downregulation of fibrotic fibroblasts leading to scar remodeling. The 
      objective of this single-site proof-of-concept IRB-approved human clinical study 
      was to evaluate the efficacy of acoustic subcision device for the improvement in 
      the appearance of hypertrophic scars. METHOD: Eleven hypertrophic scars in 10 
      participants were treated with a single 6-minute acoustic subcision application 
      without anesthesia. Posttreatment adverse events (AEs) and tolerability were 
      recorded. At 12 and 89 weeks posttreatment, scar heights and volumes were 
      measured, and participant satisfaction questionnaires were completed. Finally, at 
      the last visit the scar appearance was assessed by the Principal Investigator 
      (PI) using the Mecott Modified Scar Scale (MMSS). RESULTS: Immediately following 
      the acoustic subcision treatment, only mild, moderate erythema or pinpoint 
      bleeding were noted. The treatment sessions were considered tolerable by all 
      participants with an average pain score of 2.2 (on a 0-10 pain score with 10 
      being the worse possible pain). The 12- and 89-week assessments demonstrated mean 
      height reductions of 46.3% and 56.8%, respectively from baseline. The differences 
      in scar height were statistically significant (p < 0.01). The 12- and 89-week 
      assessments demonstrated a mean volume reduction of 63.2% and 58.1% respectively 
      from baseline. The differences in the scar volume were statistically significant 
      (p < 0.001). The PI graded an average improvement of 33.7% in scar appearance 
      using the MMSS, a statistically significant change (p < 0.001). Finally, >90% of 
      participants reported satisfaction with the improvement in their scar. 
      CONCLUSION: This proof-of-concept study showed that a single noninvasive acoustic 
      subcision treatment session can safely provide statistically significant 
      improvement in the appearance of hypertrophic scars with minimal treatment pain 
      and meaningful participant satisfaction. More work is needed on a larger number 
      of scars to verify this finding. Further improvement in appearance is expected 
      with multiple acoustic subcision treatments and/or treatments in combination with 
      currently available options. Additional trials to verify this are planned.
CI  - (c) 2022 Soliton, Inc. Lasers in Surgery and Medicine published by Wiley 
      Periodicals LLC.
FAU - LaTowsky, Brenda
AU  - LaTowsky B
AD  - Clear Dermatology and Aesthetic Center, North Scottsdale, Arizona, USA.
FAU - Robertson, David W
AU  - Robertson DW
AUID- ORCID: 0000-0003-0149-0868
AD  - Asyst Medical, LLC, Ogunquit, Maine, USA.
FAU - Capelli, Christopher C
AU  - Capelli CC
AUID- ORCID: 0000-0003-3456-8895
AD  - Soliton, Inc., Houston, Texas, USA.
LA  - eng
PT  - Case Reports
PT  - Research Support, Non-U.S. Gov't
DEP - 20220907
PL  - United States
TA  - Lasers Surg Med
JT  - Lasers in surgery and medicine
JID - 8007168
SB  - IM
MH  - Humans
MH  - *Cicatrix, Hypertrophic/etiology/pathology
MH  - Cicatrix/therapy
MH  - *Acne Vulgaris
MH  - Wound Healing
MH  - Pain
MH  - Acoustics
MH  - Treatment Outcome
PMC - PMC10087232
OTO - NOTNLM
OT  - acoustic subcision
OT  - fibrosis
OT  - hypertrophic scar
OT  - improvement in appearance
OT  - noninvasive
OT  - rapid acoustic pulse
EDAT- 2022/09/08 06:00
MHDA- 2022/12/16 06:00
PMCR- 2023/04/11
CRDT- 2022/09/07 04:42
PHST- 2022/07/24 00:00 [revised]
PHST- 2021/11/30 00:00 [received]
PHST- 2022/08/21 00:00 [accepted]
PHST- 2022/09/08 06:00 [pubmed]
PHST- 2022/12/16 06:00 [medline]
PHST- 2022/09/07 04:42 [entrez]
PHST- 2023/04/11 00:00 [pmc-release]
AID - LSM23596 [pii]
AID - 10.1002/lsm.23596 [doi]
PST - ppublish
SO  - Lasers Surg Med. 2022 Dec;54(10):1251-1260. doi: 10.1002/lsm.23596. Epub 2022 Sep 
      7.